Antimicrobial stewardship programs in Spanish hospitals: a nationwide survey
Abstract number: O87
Paño-Pardo J.R., Romero-Gómez M.P., Ortega-Gómez J.M., Martín Quirós A., Mora M., Rico A., Horcajada J.P., Padilla B., Rodríguez-Baño J.
Objectives: 1) To describe the number, distribution and main features of antimicrobial stewardship programs (ASP) in Spanish hospitals. 2) To describe the Spanish Infectious Diseases (ID) community perceptions about antimicrobial (ABX) stewardship.
Methods: An online survey was designed. The link was distributed through the e-mailing lists of several working groups of the Spanish Clinical Microbiology and Infectious Diseases Society (SEIMC). The survey was anonymously submitted.
Results: Between Sept 15 2009 and Nov 15 2009, 110 surveys representing 76 hospitals were received from all over the country. 84 surveys were completely fulfilled (76%). Distribution of the replies per hospital size is described in table 1. Most of the respondents were either ID physicians (30%) or microbiologists (29%). 35/76 hospitals (41%) had an ongoing ASP. These programs were not homogenously distributed along the country but concentrated in 4 of the 17 Spanish Autonomous Communities, especially in Catalonia. 19/30 (63%) of the ASP were not limited to a specific clinical area of the hospital and could be considered "hospitalwide" programs. Most of these ASP (70%) have been working for more than 5 years. The most frequent principles of ABX stewardship implemented in these programs were: 1) ABX streamlining or de-escalation and 2) intravenous to P.O. switch, both present in 23/30 of the surveys followed by 3) monitoring of "strategic" ABX (22/30). 26/30 (86%) of respondents stated that any physician could initially prescribe all of the antimicrobials included in the formulary. The most frequently activity carried out in the setting of Spanish ASP was 1) ABX restriction 80% followed by 2) conferences (74%) and 3) therapeutic audit and feed-back TAFB (68%). Asked for the antimicrobials that should be closely monitored, carbapenems (26/39), linezolid (11/30) and fluoroquinolones (11/30). A majority of respondents (72%) was highly pleased with this task. The most efficacious activity in the setting were thought to be the TAFB (68% considered them highly efficacious) and automatic reminders of antimicrobial duration of therapy.
Conclusions: A minority (41%) of the surveyed hospitals in Spain has an ongoing ASP and large geographical variations were observed. Few of the ASP (30%) have been implemented in the last 5 years. TAFB was perceived as the most useful intervention in the setting of ASP. Carbapenems, linezolid and fluoriquinolones were considered the ABX most suitable to be monitored.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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